Questions raised about R.I. bill to speed application process for home health-care providers

Friday

Feb 14, 2014 at 12:01 AM

PROVIDENCE, R.I. -- Three years ago, Rep. Joseph McNamara sponsored a bill that complicated matters for home health-care providers. Before offering a new service, they would have to show that the service was needed, affordable...

Randal Edgar RandyEdgar1

PROVIDENCE, R.I. -- Three years ago, Rep. Joseph McNamara sponsored a bill that complicated matters for home health-care providers. Before offering a new service, they would have to show that the service was needed, affordable and safe — following the same steps as hospitals and other medical practices.

The Warwick Democrat says the goal was to give the state some regulatory powers over a growing list of home providers.

Never, he said, did he intend for it to stop people from getting the care they needed.

But that is what happened in the case of Pentec Health Inc., a Pennsylvania-based company that sends nurses into homes to refill pain medication delivery pumps implanted in people who have debilitating diseases.

Licensed in 28 states, the company began serving several patients in Rhode Island in 2009, at the request of the patients’ doctors.

Then, in 2012, the state Department of Health told Pentec to stop. The reason: the company did not have a state license.

So began a lengthy and confrontational process that cost Pentec about $100,000 and stretched on more than six months, until the company pulled out. While Health Director Michael Fine says the department was following through on an admittedly difficult process, with the goal of protecting public health, Pentec general manager Michael Abens says he withdrew because he came to believe that state health officials “don’t want us.”

By then, Pentec’s Rhode Island patients had been without its services for nearly a year. Instead, they had to go to the hospital for pump refills.

The situation came to light in a Providence Journal op-ed piece last August, which prompted McNamara, chairman of the House Health Education and Welfare Committee, to hold a series of hearings to find out what went wrong.

Last week, McNamara and other committee members introduced a bill that retains the “certificate of need” application process for home health-care providers, but it also expands on an “expeditious review” option for providers offering new services, requiring a 30-day turnaround once a review has begun.

The bill also makes the fast review close to automatic for providers that already operate in other states, and it allows the state Health Services Council to issue such certificates on a majority vote, rather than a two-thirds majority.

Those aspects of the bill drew little attention this week when the committee sought public input, but other aspects did draw attention.

McNamara, addressing what he says are other issues that came to light as he looked into the Pentec matter, also included language that eases application requirements, in some cases, for “domestic medical tourism industry” providers — a move that would help the Florida-based Laser Spine Institute, which treats neck and back pain, open a facility in Warwick and offer services not yet available in Rhode Island.

McNamara said he added the language because the certificate of need application process focuses on Rhode Islanders, while the institute would be serving people from in state and out of state.

The bill also places a moratorium on new health-care services and equipment that require a certificate of need until July 1, 2015 — an idea that drew opposition from Greg Mancini, of the Build Rhode Island construction trade group, and David Balasco, a lobbyist for the Lifespan hospital group, who said the moratorium could hurt the local economy and providers already here.

McNamara and others say the moratorium would give the Health Department time to conduct a study of the state’s health-care needs, which would help the Health Services Council make more informed decisions. A state health-care planning council has been working on such a review for the past few years, but the effort has moved slowly because the state is providing just $150,000 a year to pay for it, said Steven Costantino, a panel co-chair and secretary for the Executive Office of Health and Human Services.

Fine said the department could do the review “and do it well” if it has “the right resources.”

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